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Individual

DR. CARL WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1491 MAIN ST, WILLIMANTIC, CT 06226-1914
(860) 456-3215
(860) 423-3351
Mailing address
1491 MAIN ST, WILLIMANTIC, CT 06226-1914
(860) 456-3215
(860) 423-3351

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000953
CT
101YM0800X
Mental Health Counselor
103-022
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103-022
PSYCHOLOGY INTERN PERMIT NUMBER
NJ
01
37LC0013400
ADDICTIONS PROFESSIONAL LICENSE NUMBER
NJ
Enumeration date
03/26/2010
Last updated
03/21/2012
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